Allogeneic HCT as consolidation in B-cell lymphomas after exposure to bispecific antibodies: a GETH-TC study

Bispecific antibodies (BsAb) targeting CD20 and CD3 have shown efficacy for relapsed/refractory (R/R) B-cell non-Hodgkin lymphoma (B-NHL), but their impact on outcomes following allogeneic hematopoietic cell transplantation (alloHCT) remains unclear. In this international, retrospective study, we compared outcomes of adult patients with R/R B-NHL undergoing first alloHCT after BsAb exposure (n = 47) versus a historical BsAb-naïve cohort (n = 101). Baseline imbalances were addressed using inverse probability of treatment weighting (IPTW) and propensity score matching (PSM). The primary end point was nonrelapse mortality (NRM); secondary end points included overall survival (OS), progression-free survival (PFS), cumulative incidence of relapse (CIR), graft-versus-host disease (GVHD), engraftment, and GVHD/relapse-free survival (GRFS). In the overall cohort, 2-year NRM did not differ significantly between BsAb-exposed and BsAb-naïve groups (IPTW: 29.1% vs 31.4%, P = 0.80; PSM: 35.8% vs. 27.9%, P = 0.43). CIR was significantly lower in BsAb-exposed patients after IPTW (7.4% vs 20.0%, P = 0.01), but not in PSM (9.5% vs 23.4%, P = 0.06). OS, GVHD, GRFS, and engraftment were comparable. In a prespecified subanalysis limited to large B-cell lymphomas, CIR differences were consistent across IPTW (6.1% vs 21.1%, P = 0.01) and PSM (9.2% vs 33.3%, P = 0.03), reinforcing a potential benefit of prior BsAb therapy. A significant improvement in PFS was observed in this subgroup with IPTW (55.5% vs 36.6%; P = 0.04), but not in PSM (P = 0.20). Prior BsAb exposure does not adversely impact alloHCT safety and may be associated with improved disease control. Prospective studies are warranted to define optimal sequencing in this high-risk population.

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Journal
Blood Advances
Published
2026-01-13
DOI
https://doi.org/10.1182/bloodadvances.2025018152
Citations
1
Primary Topic
Lymphoma Diagnosis and Treatment
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article
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article

Allogeneic HCT as consolidation in B-cell lymphomas after exposure to bispecific antibodies: a GETH-TC study

Philippe Armand, A. Sureda, Pascual Balsalobre, Giulia Losi et al.
1 citations
Blood Advances
Lymphoma Diagnosis and Treatment
36.00
article

Allogeneic HCT as consolidation in B-cell lymphomas after exposure to bispecific antibodies: a GETH-TC study

Philippe Armand, A. Sureda, Pascual Balsalobre, Giulia Losi, Yasmina Serroukh, C Solano, Alberto Mussetti, Mi Jeong Kwon, Nicole Fabbri, María Perera, María Jesús Pascual-Cascón, David Augustus Qualls, Marta Bravo Peña, Jennifer Leigh Crombie, Raquel Saldaña, Vı́ctor Navarro, Carmen Albo Lopez, J. Mariotti, Montserrat Rovira, Manuel Guerreiro, Christopher McKinnely, David Valcárcel, Leyre Bento, Lucía Lopez-Corral, Inmaculada Heras, Víctor Noriega, Manuel Jurado, Ángel Serna, Andres Sanchez-Salinas, Ya-Ting Hsu, Carlos Panizo, Maria Calbacho
article en
1 citations

Abstract

Bispecific antibodies (BsAb) targeting CD20 and CD3 have shown efficacy for relapsed/refractory (R/R) B-cell non-Hodgkin lymphoma (B-NHL), but their impact on outcomes following allogeneic hematopoietic cell transplantation (alloHCT) remains unclear. In this international, retrospective study, we compared outcomes of adult patients with R/R B-NHL undergoing first alloHCT after BsAb exposure (n = 47) versus a historical BsAb-naïve cohort (n = 101). Baseline imbalances were addressed using inverse probability of treatment weighting (IPTW) and propensity score matching (PSM). The primary end point was nonrelapse mortality (NRM); secondary end points included overall survival (OS), progression-free survival (PFS), cumulative incidence of relapse (CIR), graft-versus-host disease (GVHD), engraftment, and GVHD/relapse-free survival (GRFS). In the overall cohort, 2-year NRM did not differ significantly between BsAb-exposed and BsAb-naïve groups (IPTW: 29.1% vs 31.4%, P = 0.80; PSM: 35.8% vs. 27.9%, P = 0.43). CIR was significantly lower in BsAb-exposed patients after IPTW (7.4% vs 20.0%, P = 0.01), but not in PSM (9.5% vs 23.4%, P = 0.06). OS, GVHD, GRFS, and engraftment were comparable. In a prespecified subanalysis limited to large B-cell lymphomas, CIR differences were consistent across IPTW (6.1% vs 21.1%, P = 0.01) and PSM (9.2% vs 33.3%, P = 0.03), reinforcing a potential benefit of prior BsAb therapy. A significant improvement in PFS was observed in this subgroup with IPTW (55.5% vs 36.6%; P = 0.04), but not in PSM (P = 0.20). Prior BsAb exposure does not adversely impact alloHCT safety and may be associated with improved disease control. Prospective studies are warranted to define optimal sequencing in this high-risk population.

Blood AdvancesVol. 10(6)
Hebron University (PS), Maastricht University Medical Centre (NL), Fiona Stanley Hospital (AU), University Hospital Complex Of Vigo (ES), Hospital General Universitario Gregorio Marañón (ES), Hospital Universitari i Politècnic La Fe (ES), Maastricht University (NL), Hospital General Universitario Morales Meseguer (ES), Hospital Clínico Universitario de Valencia (ES), Hospital Universitario de Gran Canaria Doctor Negrín (ES), Grupo Español de Trasplante Hematopoyético y Terapia Celular (ES), Biogipuzkoa Health Research Institute (ES), Hospital Universitario 12 De Octubre (ES), Vall d'Hebron Institut de Recerca (ES), Institut Català d'Oncologia (ES), Hospital Regional Universitario de Málaga (ES), IPO Porto (PT), Hospital Clínic de Barcelona (ES), Hospital Universitario Virgen de las Nieves (ES), Dana-Farber Cancer Institute (US), Istituto di Ematologia di Bologna (IT), Azienda USL di Bologna (IT), Leitat Technological Center (ES), Health Research Institute of the Balearic Islands (ES), Vall d'Hebron Hospital Universitari (ES), Hospital General Universitario De Valencia (ES), Instituto de Investigación Biomédica de Salamanca (ES), Donostiako Unibertsitate Ospitalea (ES), Complexo Hospitalario Universitario A Coruña (ES), Erasmus MC Cancer Institute (NL), Hospital Universitario Virgen de la Arrixaca (ES), Hospital Universitario Son Espases (ES), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Hospital Universitario Virgen del Rocío (ES), Hospital Jerez Puerta del Sur (ES), National Cheng Kung University Hospital (TW), IRCCS Humanitas Research Hospital (IT), Universitat de Barcelona (ES)
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Openalex Percentile: Top 2%
Lymphoma Diagnosis and Treatment
36.00
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